The Importance of a Multidisciplinary Clinical Evaluation in Palliative Care: Two Clinical Cases with Bone Fracture

Abstract

Background: Palliative and oncology units should work in a multidisciplinary organization, this being the best clinical practice actually known. Multidisciplinary osteo oncology units specialized in oncologic and palliative care with the capacity for taking critical decisions is really something new in our clinical practice. Nevertheless, the oncologic patient’s approach, under palliative strategy and with a bone fracture is not always straightforward, as it requires complex decision-making that demand a multidisciplinary engagement. Case study: We present different clinical cases where we explain how we are working in taking critical decisions in palliative care breast patients with bone fracture. In the last decades, in Portugal, there has been a change of the paradigm, in which medical oncology is concerned. It has been taking over a role each time more predominant in the clinical dynamics, serving as a connecting link among the different fields. The integration of palliative care in medical oncology practice, contributes to an improvement of the patients’ quality of life and survival. Nonetheless, it should be based upon the medical evidence. The critical decision in palliative care imposes a profound reflection as it has a real impact, which cannot be underestimated. Therefore, it is important its discussion within the team, taking into consideration the patient’s global vision and the real knowledge of the technical capacities in the hospital where the patient sought treatment. We still consider that the maintenance of the patient’s contact with the hospital, physicians and medical oncology assistants, assumes a fundamental character, which reinforces its importance in the palliative care sector. Conclusion: The different therapeutic options provided for the patients want to fulfill the purpose of improving their quality of life and survival. However, they only became achievable through the multidisciplinary evaluation carried out in a clinical context, which forces us to emphasize its crucial character, not only in the clinical approach of the oncological patients as well as those who are selected for palliative care.